Chlamydia trachomatis asymptomatic urethritis recurrence among males living with HIV-1

• Published in: Revista do Instituto de Medicina Tropical de São Paulo
• Main Authors: Guilherme Almeida Rosa da Silva, Heloisa Loureiro de Sá Neves Motta, Erik Friedrich Alex de Souza, Pedro Afonso Nogueira Moises Cardoso, José Henrique Pilotto, Walter Araujo Eyer-Silva, Luiz Cláudio Pereira Ribeiro, Mônica Soares dos Santos, Marcelo Costa Velho Mendes de Azevedo, Jorge Francisco da Cunha Pinto, Rogerio Neves Motta, Fernando Raphael de Almeida Ferry
• Format: Article in Journal/Newspaper
• Language: English
• Published: Universidade de São Paulo (USP) 2018
• Subjects: HIV; AIDS; Urethritis; Chlamydia trachomatis; Neisseria gonorrhoeae; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1590/s1678-9946201860065; https://doaj.org/article/6f09af73dab74652a5e8ebcd8c887243

ABSTRACT A prevalence of 3.47% of asymptomatic Chlamydia trachomatis urethritis has been previously reported among males living with HIV infection in Brazil. This study aims to assess the recurrence of C. trachomatis urethritis three years later in the same cohort of patients and analyze associated risk factors. A total of 115 male patients diagnosed with HIV infection, with no symptoms of urethritis and observed since May of 2015 in followup visits were enrolled. They had urine samplers tested by PCR for C. trachomatis and N. gonorrhoeae between February and March 2018. Results: Three of the four patients who had asymptomatic C. trachomatis urethritis three years before were recurrently positive for C. trachomatis urethritis. Two new patients were diagnosed as positives, accounting for a total asymptomatic C. trachomatis urethritis prevalence of 4.34%. The prevalence during the whole study was 5.21%. The relative risk for a new urethritis episode among those previously diagnosed with urethritis is RR=41.62 (95% CI: 9.42-183.84), p < 0.01. Patients who presented asymptomatic urethritis anytime and who were recurrently positive for C. trachomatis had a lower mean age (p<0.01). Married individuals were protected regarding asymptomatic urethritis [p<0.01, OR = 0.04 (0.005-0.4)] and had lower risk to develop recurrence [p<0.01, RR = 0.86 (0.74-0.99)]. Illicit drugs users had risk associated to asymptomatic urethritis [p=0.02, OR= 5.9 (1.03-34)] and higher risk to develop recurrence [p<0.01, RR=1.1 (1-1.22)]. Conclusion: The recurrence of asymptomatic C. trachomatis urethritis after treatment among males living with HIV infection in Brazil can be considered high and should not be neglected.